Organization
EAST MOUNTAIN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN G HAMILTON DDS (GENERAL DENTIST)
(801) 377-0037
Entity
Organization
Contact information
Practice address
2335 S STATE ST, SUITE 200, PROVO, UT 84606-6576
(801) 377-0037
(801) 377-3141
Mailing address
2335 S STATE ST, SUITE 200, PROVO, UT 84606-6576
(801) 377-0037
(801) 377-3141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4926995
UT
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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